Total knee replacement surgery is associated with significant pain in the immediate postoperative period, especially in movement. In turn, this is associated with more subsequent chronic pain.
There are multiple options and the tendency is to perform increasingly distal nerve blocks to minimize limb weakness and thus allow early rehabilitation. In 2012, in an oral communication, Sanjay Sinha described a new nerve block called iPACK ("Interspace between the Popliteal Artery and the Capsule of the posterior Knee"). There are few studies on the efficacy of such a blockade so far, but none comparing the groups saphene + sciatic blocks vs. saphene + iPACK blocks.
Therefore, this study aims to provide more information on the effectiveness this nerve blocks, in total knee replacement, in terms of analgesia and motor function.
Patients with osteoarthritis scheduled for total primary knee arthroplasty with same surgeons
Locoregional anesthesia
Age equal to or greater than 18 years
Consent to participate in the study
Age under 18 years old
General anesthesia
Allergy to local anesthetics
Severe kidney failure (Cr ≥ 2mg / dL)
Parallel
IPACK block with Bupivacaine 0.25% with adrenaline
DrugThe iPACK in performed in the popliteal fossa about 1 finger breath above the patella, ecoguided. That aims to anesthetize the articular branches to the posterior aspect of the knee in the popliteal region.
Pain at rest
Measured by the numerical visual scale at 6 hours after intradural anesthesia, minimum of 0 and maximum of 10, where means no pain and 10 means the worst pain in the life of the patient.
Pain at rest
Measured by the numerical visual scale at 24 hours after intradural anesthesia, minimum of 0 and maximum of 10, where means no pain and 10 means the worst pain in the life of the patient.
Pain at rest
Measured by the numerical visual scale at 48 hours after intradural anesthesia, minimum of 0 and maximum of 10, where means no pain and 10 means the worst pain in the life of the patient.
Pain at movement
Measured by the numerical visual scale at 48 hours after intradural anesthesia, minimum of 0 and maximum of 10, where means no pain and 10 means the worst pain in the life of the patient.
Opioids dose
Measured in milligrams of intravenous morphine hydrochloride daily.
Opioids dose
Measured in milligrams of intravenous morphine hydrochloride daily.
Opioids dose
Measured in milligrams of intravenous morphine hydrochloride daily.
Discharge days
Time to discharge measured in days
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